Provider Demographics
NPI:1245588607
Name:AYERS, SANDRA HYLTON (RN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:HYLTON
Last Name:AYERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-0070
Mailing Address - Country:US
Mailing Address - Phone:276-236-7935
Mailing Address - Fax:276-236-1815
Practice Address - Street 1:818 GLENDALE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2311
Practice Address - Country:US
Practice Address - Phone:276-236-7935
Practice Address - Fax:276-236-1815
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001115299163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse